放射性膀胱损伤病理机制及其治疗探析:基于“主客交”理论

Discussion on the Pathological Mechanism and Treatment of Radiation Bladder Injury Based on the Theory of “Pathogen Invading Nutrient and Blood Aspects”

放射性膀胱损伤是盆腔肿瘤放疗过程中出现的常见并发症之一,中医多认为该病病机为本虚标实,本虚为气阴两虚,标实为湿热、浊毒、瘀血胶着不解,其发生、发展与“主客交”正虚邪实、客邪胶固于血脉的病机相似。“主客交”理论中的邪实主要指的是湿浊、痰瘀等病理产物,与现代研究中射线、氧自由基、炎症细胞、炎性因子等性质相似,同时其侵袭血脉经络,造成了持续性损伤的渐进性加重,与放射性膀胱损伤机制相似,而正虚抗邪无力,毒邪伤正,正气亏虚,是进一步加重该病的根本原因之一。因此基于“主客交”理论结合现代分子机制研究,可以更好解析该病病理机制,为该病的中医临床治疗提供新思路。

Radiation-induced bladder injury is one of the commom complications during the radiotherapy for pelvic tumor. Traditional Chinese medicine concluded that the pathogenesis of RIBI is deficiency in essence and excess in symptoms. The deficiency in essence is both Qi and Yin deficiency, the excess in symptoms has manifested by combining damp-heat, turbidity-poison and blood-stasis with each other together. The occurrence and development of the pathogenesis are similar to “host-guest interaction” theroy which included the vital Qi deficiency and pathogens invasion, pathogens adhere to the blood. The pathogens invasion of the theory of “host-guest interaction” mainly refers to pathological products such as damp-heat and phlegm-blood-stasis. They are similar to the characters of radiation, oxygen radicals, inflammatory cells, inflammatory factors and so on. At the same time, they attacked blood meridians and induced increasing continued injury, that is similiar to the pathogenesis of RIBI.While one of the reason why the disease has becoming heavier is that vital Qi deficiency couldn’t resist pathogens, poison pathogens harmed vital Qi, and vital Qi deficiency.So the study based on the theory “host-guest interaction” combined with modern molecular mechanism, for better understanding the pathogenesis of RIBI and supporting news iedas for Traditional Chinese Medicine clinical therapy.